Commonwealth of Massachusetts
Executive Omce ofEnvironmentol ~ g o r s
ENF
Executive Office of Environmental EOEA No.: 33 Affairs H MEPA Office MEPA A n a l y s d k k a r / ' / . Phone: 617-626- /d3d
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Environmental Notification Form
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The information requested on this form must be completed to begin MEPA Review in accordance with the provisions of the Massachusetts Environmental Policy Act, 301 CMR 11.oo.
Does this project meet or exceed a mandatory EIR threshold (see 301 CMR 11.03)? WYes Has this project been filed with MEPA before? [ I Y e s (EOEA No. ) Has any project on this site been filed with MEPA before? []Yes (EOEA No ) Is this an Expanded ENF (see 301 CMR 11.05(7)) requesting: [XIYes a Single EIR? (see 301 CMR i1.06(8)) a Special Review Procedure? (see 301CMR 11.09) OYes a Waiver of mandatory EIR? (see 301 CMR 11.11) OYes a Phase I Waiver? (see 301 CMR IIII) OYes
ON0 [XINO [XINO
Identify any financial assistance or land transfer from an agency of the Commonwealth, including the agency name and the amount of funding or land area (in acres): None Are you requesting coordinated review with any other federal, state, regional, or local agency? O Y e s [XINO
List Local or Federal Permits and Approvals: Local: Site Plan Approval, Building Permit, Driveway Permit State: Indirect Highway Access Permit (IHAP) Which ENF or EIR review threshold(s) does the project meet or exceed (see301CMR 11 03): Land Water [7 Energy [7 ACEC Summary of Project Size
[7 Rare Species [7 Wastewater [7 Air [7 Regulations
Existing
[7 Wetlands. Waterways. & Tidelands
Transportation
[7 Solid & Hazardous Waste [7 Historical & Archaeological
Resources
Change
Total
State Permits & Approvals Superceding Order of Conditions Chapter 91 License [7 401 ... . Quality Water
& Environmental Impacts
I Acres of im~erviousarea
1
5.06 +
1.22
6.28
I
I Gross square footage i/ Number of housing units I Maximum heiaht (in feet)
Vehicle trips per day
1 I 1
42,230 0 30+1-
1 I 1
42,130 0 lo+/-
1 I 1
84,360
0 40+/-
1 I 1
Approvals) - Specify:
I I
Parking spaces Gallonsldav (GPD) of water use GPD wastewater generation1 treatment Length of waterlsewer mains (in miles)
I 1
50
310
1 3 6 0
1 1
IGPDwaterwithdrawal
1
825
1
7; 5
0
1
4382
1
3g8:
0
1 1
473: 0
5207